Provider Demographics
NPI:1437046075
Name:MALONE BATISTA, YAMILKA TATIANA
Entity type:Individual
Prefix:
First Name:YAMILKA
Middle Name:TATIANA
Last Name:MALONE BATISTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 ASHE DR APT B5
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29617-3262
Mailing Address - Country:US
Mailing Address - Phone:787-466-2530
Mailing Address - Fax:
Practice Address - Street 1:430 ROPER MOUNTAIN RD UNIT 440-A
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-4236
Practice Address - Country:US
Practice Address - Phone:864-204-0440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCRBT-25-426536106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician